Provider Demographics
NPI:1780094177
Name:ARIGBEDE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ARIGBEDE HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BOLAJI
Authorized Official - Middle Name:KEHINDE
Authorized Official - Last Name:ARIGBEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-690-6040
Mailing Address - Street 1:301 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3228
Mailing Address - Country:US
Mailing Address - Phone:870-732-5555
Mailing Address - Fax:
Practice Address - Street 1:301 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3228
Practice Address - Country:US
Practice Address - Phone:870-732-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR201921742Medicaid